Impact of unilateral mastectomy on body posture: A prospective longitudinal observational study.

Objective: Unilateral mastectomy is known to induce postural alterations, yet the temporal development pattern of these changes remains elusive. This study aimed to explore the impact of unilateral mastectomy on body posture. Methods: A prospective, longitudinal, observational study with a one-group repeated-measures design was conducted. Patients undergoing unilateral mastectomy were recruited from a university-affiliated hospital in Western China and monitored for 12 months post-surgery. A trained nurse assessed seven postural baseline parameters on the day of suture removal and at 3, 6, and 12 months after unilateral mastectomy. Two parameters were in the sagittal plane (forward head posture and trunk rotation angle), and five were in the coronal plane (neck tilt, shoulder asymmetry, scapular asymmetry, scapular asymmetry relative to the spine, and pelvic tilt). Results: The final analysis included 159 patients. Baseline prevalence of most postural abnormalities ranged from 50.94% to 59.75%, with mean deviations between 2.74 and 4.51 mm. At 12 months post-mastectomy, prevalence and mean deviations increased by more than 30% and 3.50 mm, respectively, compared to baseline. Postural abnormalities increased gradually in the first 3 months, notably between the 3rd and 6th months, and slowed between the 6th and 12th months. On the mastectomy side, coronal plane abnormalities significantly increased within 12 months: earlobe to acromion distance (Wald χ2 = 45.283, P < 0.001), depressed shoulder height (Wald χ2 = 42.253, P < 0.001), depressed scapula height (Wald χ2 = 31.587, P < 0.001), scapula to spine distance (Wald χ2 = 45.283, P < 0.001), and elevated pelvic height (Wald χ2 = 48.924, P < 0.001). Conclusions: Postural changes are common post-unilateral mastectomy, with prevalence and deviation increasing gradually, particularly between 3 and 6 months post-mastectomy. Early rehabilitation initiation is recommended to mitigate postural changes. Trial registration: ChiCTR2000040897.

[Clinical Study of Peripherally Inserted Central Catheter-Related Thrombosis and Its Influence on the Blood Flow Status of the Inserted Veins in Cancer Patients].

Objective: To investigate the clinical features of peripherally inserted central catheter (PICC)-related thrombosis (PICCRT) within 2 weeks after PICC placement in cancer patients and its dynamic influence on the blood flow status of veins inserted with catheter, and to provide support for implementing thrombosis prevention and control measures. Methods: Between May 2019 and July 2020, patients who had solid tumors and who had PICC were prospectively enrolled at West China Hospital, Sichuan University. Scheduled color Doppler imaging was performed to examine the status of PICCRT formation at 8 points of time, with the first one conducted one day before the insertion of PICC and the other 7 completed within 2 weeks after the insertion of PICC. Then, based on whether patients had PICCRT, the patients were divided into two groups, a non-PICCRT group and a PICCRT group. The PICCRT group was further divided into two subgroups, an asymptomatic PICCRT group and a symptomatic PICCRT group, according to whether the patients had thrombosis-related symptoms and signs. Comparisons were made to study the incidence of PICCRT and the vascular diameter and the blood flow velocity in the veins inserted with catheters at different points of time in the patients of different groups. Results: Among 173 cancer patients in the cohort, 126 (72.8%) developed PICCRT, all of which occurred within 1 week after PICC insertion. There were 95 cases of asymptomatic PICCRT and 31 cases of symptomatic PICCRT. Before and after PICC insertion, the vascular diameter of both the asymptomatic and symptomatic PICCRT groups was significantly smaller than that of the non-PICCRT group and the blood flow velocity was significantly slower than that of the non-PICCRT group, with the difference continuing to increase with the prolongation of catheter indwelling time. Conclusion: Inserting catheters in veins with bigger vascular diameter and faster blood flow velocity may help reduce the incidence of PICCRT. The first week post catheter insertion is the key intervention period for the prevention of PICCRT.

A recurrent inflammatory myofibroblastic tumor patient with two novel ALK fusions: a case report.

Background: Inflammatory myofibroblastic tumor (IMT) is a rare disease that mainly involves the lung and the abdomen. The gold standard of the IMT treatment is radical surgery, while chemotherapy and radiotherapy are represented usually for unresectable lesions. Anaplastic lymphoma kinase (ALK) rearrangements are present in approximately 50% of IMT patients, and several clinical trials of ALK tyrosine kinase inhibitors (TKIs) in the treatment of ALK-positive IMT patients are underway. Case Description: We reported a case of IMT in the right pelvic cavity. Initially, the patient underwent resection of multiple lesions. Unfortunately, the patient's tumor recurred half a year later, and enhanced computerized tomography (CT) of the whole abdomen revealed multiple low-density masses. Then the patient underwent resection of the recurrent tumors. Immunohistochemical staining exhibited the expression of ALK in the tumor cells, and next-generation sequencing (NGS) technology revealed two novel ALK fusions, ALK-ribosome binding protein 1 (RRBP1) and hydroxyacid oxidase 1 (HAO1)-ALK fusions. These fusions were able to be transcribed and captured by RNA level. And the two fusions have not been reported in the IMTs. Conclusions: This case expanded the range of ALK fusion types and provided a promising molecular-targeted treatment strategy. In addition, the two novel ALK fusions may be the recurrent oncogenic mechanism in clinically aggressive IMT.

Correction: Xie et al. Synergistic Effect of MoS2 and SiO2 Nanoparticles as Lubricant Additives for Magnesium Alloy-Steel Contacts. Nanomaterials 2017, 7, 154.

In the original publication [...].

LINC00665 interacts with BACH1 to activate Wnt1 and mediates the M2 polarization of tumor-associated macrophages in GC.

Gastric cancer (GC) remains one of the prevalent causes of cancer-related deaths globally. Long non-coding RNAs (lncRNAs) have been associated with different cancers. The polarization of macrophages towards the M2 (alternatively activated) phenotype promotes immunologic tolerance and can induce gastric tumorigenesis. Thus far, lncRNAs have been shown to modulate the differentiation of immune cells. Here, we investigated the biological effects of LINC00665 on the progression of GC and explored the mechanisms underlying its ability to mediate the polarization of macrophages towards the M2 phenotype. We report that the levels of LINC00665 were increased in GC tissues. Furthermore, this increase in LINC00665 expression could be associated with decreased overall survival (OS), progression-free survival (PFS), and post-progression survival (PPS). Using cell-based macrophage polarization models, we demonstrated that LINC00665 upregulation in GC cells facilitated the polarization of macrophages towards the M2 but not M1 (classically activated) phenotype. Furthermore, the loss of LINC00665 prevented the M2 polarization of macrophages. Mechanically, we identified that Wnt1 was the downstream target of LINC00665. Additionally, LINC00665 could directly interact with the transcription factor BTB domain and CNC homology 1 (BACH1). The interaction between LINC00665 and BACH1 resulted in the activation and binding of BACH1 to the Wnt1 promoters. Furthermore, BACH1 silencing could inhibit GC progression, which highlighted a crucial role for BACH1 in LINC00665-mediated Wnt1 activation. In addition, genetic Wnt1 overexpression effectively abolished the repression of Wnt signaling after BACH1 depletion and mediated GC development by supporting M2 macrophage polarization. In conclusion, we report that LINC00665 modulates M2 macrophage polarization and suggest that it may facilitate macrophage-dependent GC progression.

Remarkable response to anti-PD1 immunotherapy in refractory metastatic high-grade myxofibrosarcoma patient: A case report.

INTRODUCTION: Myxofibrosarcoma (MFS) is a locally aggressive tumor and has the potential to be fatal because of distant metastasis. Immunotherapy targeting either programmed cell death protein 1 (PD-1) or programmed death ligand 1 (PD-L1) has recently shown a curative effect on multiple cancers including melanoma, non-small cell lung cancer, and renal cell carcinoma. Although the immunotherapy has been applied in sarcoma, there is little information about the efficiency to treat metastatic MFS. PATIENT CONCERNS: A 42-year-old male presented to the clinic with a mass in the left thigh. Mass resection and ligament replacement surgery were performed. DIAGNOSES: The patient was diagnosed as high-grade MFS (federation nationale des centres de lutte contre le cancer, Grade 3) with pulmonary metastasis. INTERVENTIONS: In the past few years, he was treated with surgery, chemoradiotherapy, and Anlotinib (an angiogenesis inhibitor), but the metastatic lesion continued to progress. About 40% to 50% of tumor cells in his pulmonary tissues were showed positive PD-L1 expression and his tumor mutational burden was 215Muts. Thus, he received Camrelizumab (PD-1 inhibitor). OUTCOMES: Six months after the initiating immunotherapy of Camrelizumab, the size of pulmonary lesions showed marked shrinkage, indicating a partial response. After a follow-up of 18 months, the patient remained in good condition without progressive disease. CONCLUSION: This case described here demonstrated that immunotherapy of PD-1 inhibitor is a promising treatment option for refractory MFS with PD-L1 positive or tumor mutational burden -high, which could contribute to effective tumor response.

Facile synthesis of ternary flexible silica aerogels with coarsened skeleton for oil-water separation.

Ternary flexible silica aerogels were synthesized using a facile sol-gel process without solvent exchange and surface modification using dimethyldiethoxysilane (DEDMS), methyltriethoxysilane (MTES) and tetraethoxysilane (TEOS) via ambient pressure drying. The skeleton morphology of the aerogels was precisely controlled by the DEDMS/TEOS molar ratio (D). The effect of the morphology of the aerogel skeleton on the mechanical properties and the adsorption capacity was investigated. As the D increased, the morphology of the aerogel skeleton gradually changed from a fragment structure to a coarsened structure, and finally to a chain-like structure. The prepared coarsened structure aerogel exhibited a low density of 0.095 g cm-3, a compressible amount reaching up to 78.2%, a Young's modulus as low as 14 kPa, a superhydrophobicity with a contact angle of 154.8° and an excellent adsorption capacity of 8.7-15.4 g g-1. Furthermore, the outstanding recycling ability and corrosion resistance made the aerogels suitable for oil-water separation in corrosive environments.

ß-Defensin 129 Attenuates Bacterial Endotoxin-Induced Inflammation and Intestinal Epithelial Cell Apoptosis.

Defensins have attracted considerable research interest worldwide because of their potential to serve as a substitute for antibiotics. In this study, we characterized a novel porcine ß-defensin (pBD129) and explored its role in alleviating bacterial endotoxin-induced inflammation and intestinal epithelium atrophy. The pBD129 gene was cloned and expressed in Escherichia coli. A recombinant pBD129 protein was also purified. To explore its role in alleviating the endotoxin-induced inflammation, mice, with or without lipopolysaccharide (LPS) challenge were treated by pBD129 at different doses. The recombinant pBD129 showed significant antimicrobial activities against the E. coli and Streptococcus with a minimal inhibitory concentration (MICs) of 32 µg/mL. Hemolytic assays showed that the pBD129 had no detrimental impact on cell viabilities. Interestingly, we found that pBD129 attenuated LPS-induced inflammatory responses by decreasing serum concentrations of inflammatory cytokines, such as the IL-1ß, IL-6, and TNF-α (P < 0.05). Moreover, pBD129 elevated the intestinal villus height (P < 0.05) and enhanced the expression and localization of the major tight junction-associated protein ZO-1 in LPS-challenged mice. Additionally, pDB129 at a high dose significantly decreased serum diamine oxidase (DAO) concentration (P < 0.05) and reduced intestinal epithelium cell apoptosis (P < 0.05) in LPS-challenged mice. Importantly, pBD129 elevated the expression level of Bcl-2-associated death promoter (Bcl-2), but down-regulated the expression levels of apoptosis-related genes such as the B-cell lymphoma-2-associated X protein (Bax), BH3-interacting domain death agonist (Bid), cysteinyl aspartate-specific proteinase-3 (Caspase-3), and caspase-9 in the intestinal mucosa (P < 0.05). These results suggested a novel function of the mammalian defensins, and the anti-bacterial and anti-inflammatory properties of pBD129 may allow it a potential substitute for conventionally used antibiotics or drugs.

In vitro inhibition of tumor growth by low-dose iron oxide nanoparticles activating macrophages.

Macrophages as immunocyte are attracting more and more attention in cancer therapy. Our previous study observed that dimercaptosuccinic acid (DMSA)-coated Fe3O4 magnetic nanoparticles triggered comprehensive immune responses of mouse macrophages (RAW264.7 cells) and induced production of many kinds of cytokines. This study investigated the effects of Fe3O4 magnetic nanoparticles on RAW264.7 cells proliferation, migration, and inhibition of tumor growth in vitro. Fe3O4 magnetic nanoparticles had an average size of about 11 nm with good dispersibility and uniformity. Fe3O4 magnetic nanoparticles internalized efficiently into RAW264.7 cells. Through Cell Counting Kit-8 (CCK-8) detection, the proliferation of RAW264.7 cells significantly increased by the low-dose Fe3O4 magnetic nanoparticles (50 µg/mL) treatment. The results of wound-healing and Transwell assays both displayed a significant promotion of the RAW264.7 cells migratory capability compared with control group ( P<0.01). It is interesting to find that a large number of proliferated RAW264.7 cells were activated to surround quickly and attack mouse liver cancer cell (Hepa1-6) cells by Fe3O4 magnetic nanoparticles. The growth of Hepa1-6 cells was effectively inhibited according to microscope imaging and flow cytometry analysis. The inhibition may be cooperative effects of RAW264.7 cells proliferation, migration, and immune activation. The results suggest potential clinical value of low-dose iron oxide nanomaterials in cancer therapy.

Dietary Daidzein Supplementation During Pregnancy Facilitates Fetal Growth in Rats.

SCOPE: Daidzein, a natural isoflavone with estrogen-like activity, has been implicated in the regulation of reproductive performance in mammals. However, little is known about the molecular mechanisms involved. Here, the effects and potential mechanisms of daidzein supplementation on fetal growth in rats have been explored. METHODS AND RESULTS: Thirty-six pregnant Sprague-Dawley rats are assigned to receive either an AIN-93M diet or an AIN-93M diet supplemented with 50 mg kg-1 daidzein. Blood, placental, and fetus samples were collected on day 15 of gestation. It is shown that daidzein significantly improves the rat reproductive performance, which is associated with a higher fetus number, and the weight of the fetus and placenta (p < 0.05). Daidzein also increases the maternal serum estrogen and leptin concentrations, and the activity of superoxide dismutase (SOD) (p < 0.05). Notably, the isobaric tags for relative and absolute quantification (iTRAQ)-based proteomics analysis identifies 43 differentially expressed (DE) proteins in the placenta upon daidzein supplementation (p < 0.05). Interestingly, critical proteins involved in amino acid transport and metabolism, embryonic development, ubiquitination processes, and immune responses are upregulated in the daidzein group (p < 0.05). CONCLUSION: These results not only indicate a beneficial effect of daidzein supplementation on reproductive performance but also offer potential mechanisms behind daidzein-facilitated fetal growth in rats.

Chlorogenic Acid Improves Intestinal Development via Suppressing Mucosa Inflammation and Cell Apoptosis in Weaned Pigs.

Chlorogenic acid (CGA) is a naturally occurring polyphenol in the human diet and plants, exhibiting antioxidant and anti-inflammatory activities. This study was conducted to investigate the effects of CGA on intestinal development and health in weaned pigs. Twenty-four weaned pigs were randomly assigned to two treatments and fed with a basal diet or a basal diet supplemented with 1000 mg/kg CGA. After a 14 d trial, samples were collected. Compared with the control group, CGA supplementation decreased the serum tumor necrosis factor-α, interleukin-6, and interleukin-1ßIL-6 concentrations and elevated the serum immunoglobulin G and jejunal secretory immunoglobulin A concentrations. Meanwhile, jejunal villus height, duodenal and jejunal villus width, and jejunal and ileal villus height/crypt depth were increased by CGA. CGA not only decreased the number of duodenal and jejunal cells in the G0G1 phase but also increased the number of jejunal and ileal cells in the S phase. The percentages of late and total apoptotic cells in jejunum and the ratio of B-cell lymphoma-2-assiciated X protein to B-cell lymphoma-2 (Bcl-2) in duodenum and jejunum were also decreased by CGA supplementation. Finally, CGA upregulated the expression level of Bcl-2 in duodenum and jejunum, whereas it downregulated the expression levels of caspase-3 in duodenum and jejunum, caspase-9 in jejunum, as well as Fas in jejunum and ileum. This study suggested that the beneficial effects of CGA on intestinal development and health are partially due to improvement in immune defense and suppression in excessive apoptosis of intestinal epithelial cells in weaned pigs.

Tribological Behaviors of Graphene and Graphene Oxide as Water-Based Lubricant Additives for Magnesium Alloy/Steel Contacts.

The tribological behaviors of graphene and graphene oxide (GO) as water-based lubricant additives were evaluated by use of a reciprocating ball-on-plate tribometer for magnesium alloy-steel contacts. Three sets of test conditions were examined to investigate the effect of concentration, the capacity of carrying load and the endurance of the lubrication film, respectively. The results showed that the tribological behaviors of water can be improved by adding the appropriate graphene or GO. Compared with pure deionized water, 0.5 wt.% graphene nanofluids can offer reduction of friction coefficient by 21.9% and reduction of wear rate by 13.5%. Meanwhile, 0.5 wt.% GO nanofluids were found to reduce the friction coefficient and wear rate up to 77.5% and 90%, respectively. Besides this, the positive effect of the GO nanofluids was also more pronounced in terms of the load-carrying capacity and the lubrication film endurance. The wear mechanisms have been tentatively proposed according to the observation of the worn surfaces by field emission scanning electron microscope-energy dispersive spectrometer (FESEM-EDS) and Raman spectrum as well as the wettability of the nanofluids on the magnesium alloy surface by goniometer.

Synergistic Effect of MoS2 and SiO2 Nanoparticles as Lubricant Additives for Magnesium Alloy-Steel Contacts.

The tribological performances of the SiO2/MoS2 hybrids as lubricant additives were explored by a reciprocating ball-on-flat tribometer for AZ31 magnesium alloy/AISI 52100 bearing steel pairs. The results demonstrated that the introduction of SiO2/MoS2 hybrids into the base oil exhibited a significant reduction in the friction coefficient and wear volume as well as an increase in load bearing capacity, which was better than the testing results of the SiO2 or MoS2 nanolubricants. Specifically, the addition of 0.1 wt % nano-SiO2 mixed with 1.0 wt % nano-MoS2 into the base oil reduced the friction coefficient by 21.8% and the wear volume by 8.6% compared to the 1.0 wt % MoS2 nanolubricants. The excellent lubrication behaviors of the SiO2/MoS2 hybrid nanolubricants can be explained by the micro-cooperation of different nanoparticles with disparate morphology and lubrication mechanisms.

An Investigation on the Tribological Performances of the SiO2/MoS2 Hybrid Nanofluids for Magnesium Alloy-Steel Contacts.

Hybrid nano-materials offer potential scope for an increasing numerous novel applications when engineered to deliver availably functional properties. In the present study, the SiO2/MoS2 hybrid nanoparticles with different mass ratios were employed as lubricant additives in the base oil, and their tribological properties were evaluated using a reciprocating ball-on-plate tribometer for magnesium alloy-steel contacts. The results demonstrate that the SiO2/MoS2 hybrid nanoparticles exhibit superior lubrication performances than individual nano-SiO2 or nano-MoS2 even in high load and diverse velocity cases. The optimal SiO2/MoS2 mixing ratio and the concentration of SiO2/MoS2 hybrid nanoparticles in the base oil are 0.25:0.75 and 1.00-1.25 wt%, respectively. The excellent lubrication properties of the SiO2/MoS2 hybrid nanoparticles are attributed to the physical synergistic lubricating actions of nano-SiO2 and nano-MoS2 during the rubbing process.

[An analysis of clinical characteristics, etiologies and prognosis of 218 patients with infective endocarditis].

OBJECTIVE: To describe the profile of patients with infective endocarditis (IE) and assess prognostic factors of IE. METHODS: Clinical and etiology data of 218 patients with IE were collected retrospectively from January 2011 to January 2013. The distribution and antimicrobial susceptibilities of pathogens causing IE were evaluated. Prognostic factors associated with IE were determined by univariate and multivariate regression analysis. RESULTS: There were 148 men and 70 women with age of (46.0 ± 14.6) years. Ninety-five (43.6%) of them had heart diseases, including 72 cases (33.0%) of congenital heart disease and 23 cases (10.6%) of chronic rheumatic heart disease. Vegetations were detected by echocardiography in 171 (78.4%) patients. Microorganisms causing IE were identified in 84 cases (38.5%) cases. Streptococcus viridans was the dominant pathogen, accounted for 63.1% of all the pathogens, followed by Staphylococcus (13.1%) and Enterococcus (4.8%). Totally 7/11 Streptococcus viridans was susceptible to penicillin, while 100% susceptible to the third and fourth generation cephalosporins, vancomycin and linezolid. One hundred and eighty cases underwent operations. The in-hospital mortality rate of IE was 3.2%. In univariate regression, health care-associated infection, prosthetic valve, anemia and chest symptoms (distress or pain) were related to the increased risk of mortality in patients with IE, while surgery appeared to be a protective factor. In the logistic regression model, the variables significantly associated with IE prognosis were health care-associated infection (OR = 17.03, 95%CI 1.76-164.75, P = 0.014) and anemia (Hb < 90 g/L) (OR = 13.47, 95%CI 2.46-73.60, P = 0.003) and surgery treatment (OR = 0.17, 95%CI 0.03-0.97, P = 0.047). CONCLUSIONS: Although Streptococcus viridans is the most common pathogen causing IE, the pathogens of IE become versatile. The antibacterial activity of penicillin against Streptococcus viridans is low. Health care-associated infection and anemia are risk factors of IE prognosis, while surgery treatment is a protective factor of severe IE.

[The incidence and risk factors for heterogeneous vancomycin intermediate Staphylococcus aureus].

OBJECTIVES: To investigate the prevalence of heterogeneous vancomycin intermediate Staphylococcus aureus (hVISA) and the sensitivity of hVISA to novel antibiotics, and to explore the risk factors and infection attributable mortality associated with hVISA infection. METHODS: A total of 456 methicillin resistant Staphylococcus aureus (MRSA) isolates were isolated in Zhongshan Hospital from January, 2008 to November, 2010. All MRSA isolates were investigated for hVISA by two agar screening methods BHIA5T (brain-heart infusion containing teicoplanin 5 mg/L) or BHIA6V (brain-heart infusion containing vancomycin 6 mg/L), as well as macroEtest method (MET). Possible hVISA isolates were tested by modified population analysis profile-area under the curve (PAP-AUC). The minimal inhibitory concentrations (MICs) of vancomycin, teicoplanin and linezolid were determined by microbroth dilution as recommended by Clinical Laboratory Standards Institute (CLSI). The contribution difference between hVISA and vancomycin susceptible Staphylococcus aureus (VSSA) in different MIC range was compared. A retrospective case-control study of the patients with hVISA infection or VSSA infection was carried out and statistical analysis was performed using t test, Mann-Whitney test, χ(2) test and Fisher exact test. RESULTS: A total of 105 isolates of hVISA were screened by BHIA5T and BHIA6V (23.0%) with other 23 isolates by MET (5.0%) and 21 by PAP-AUC (4.6%). All isolates were 100% sensitive to vancomycin, teicoplanin and linezolid. The vancomycin MIC [(1.76 ± 0.16) mg/L] in hVISA group was significantly higher than that in VSSA group [(1.09 ± 0.07) mg/L, P < 0.01], which was a potential risk factor for hVISA infection. The retrospective study showed chronic obstructive pulmonary disease (COPD) was also a risk factor for hVISA infection of the lower respiratory tract. No significant difference in infection attributable mortality was showed between the hVISA group and the VSSA group. CONCLUSIONS: The overall prevalence of hVISA in Zhongshan Hospital is estimated as 4.6%, while the prevalence of hVISA isolated from blood is as high as 12.5%. All isolates are 100% sensitive to vancomycin and linezolid. COPD is a risk factor for hVISA infection of the lower respiratory tract.

[The characteristics of CT imaging and diagnosis of pulmonary cryptococcosis in 42 cases with non-acquired immune deficiency syndrome].

OBJECTIVE: To further elucidate the CT characteristics and diagnostic approaches to non-acquired immune deficiency syndrome patients with pulmonary cryptococcosis. METHODS: The histories of forty-two pulmonary cryptococcosis (PC) patients diagnosed in Zhongshan Hospital from 2003-2008 were collected and analyzed for demography data, underlying conditions, clinical symptoms, chest CT and diagnostic studies. RESULTS: None of the 42 PC patients had avian or its feces contacting history, and 71.4% (30/42) of them were immunocompetent. The most frequent CT lesions were multiple nodules (67.9%) with peripheral predominance (67.9%), and cavitations (50%) often presented within them. Masses/consolidation (31.4%) and patching lesions (2.9%) could exist occasionally. Positive detection rates of non-aggressive examinations including sputum, bronchoalveolar lavage fluid and bronchofibroscopy aspiration were 4.3%, 8.3% and 6.3% respectively, while those of aggressive approaches including transbronchial lung biopsy (TBLB), thin needle aspiration biopsy (TNAB) and pneumonectomy by surgery were 64.7%, 64.3% and 100% respectively. Non-aggressive serum cryptococcus antigen test was performed in 14 patients who had been diagnosed by histopathology or pathogen culture, and all of them were positive. CONCLUSION: Our study suggests that PC is common in immunocompetent population. Avian or its feces contacting is not so important as used opinion to PC differential diagnosis. CT characteristics of PC are diversiform and always change very slowly. Besides the most frequent multiple nodules with subpleural predominance, pulmonary lesions can present as masses, consolidation or patching. Aggressive techniques such as TBLB and TNAB are benefit to clinical diagnosis of PC, and non-aggressive serum cryptococcus antigen test may be promising for its early diagnosis as well as clinical course follow-up and therapeutic effect evaluation.